The term “healthy obese” has gained popularity lately to describe individuals with healthy metabolic markers like fasting blood sugar, triglyceride levels and blood pressure. Although poor health markers often coexist with obesity, they can also be present in lower weight individuals (referred to as “metabolically unhealthy lean”). Recent research challenges the accuracy of these definitions, however.

In October, a study published in the journal Diabetes Care found “healthy obese” individuals to be at a higher mortality risk than “unhealthy lean” individuals. Researchers studied the data of more than 140,000 participants in 14 studies to assess their risks of developing type 2 diabetes. They found those who were classified as “metabolically healthy obese” to be at a higher risk of type 2 diabetes than those who were lean but showed poor metabolic markers.

New research published in the International Journal of Epidemiology builds on the idea of the “fat but fit” theory’s shortcomings. The new study by a team at the Department of Community Medicine and Rehabilitation, Geriatric Medicine at Umeå University in Sweden analyzed data of 1.3 million men to determine their aerobic fitness level.

Over a period of time averaging 29 years, the men measuring in the top 20 percent for aerobic fitness were found to be at a 48 percent lower risk of all-cause mortality than those in the bottom 20 percent. However, the benefits of high aerobic fitness were lower for those who were obese. For aerobically fit obese men, there was no lower risk of death identified. Compared with normal-weight men with low aerobic fitness, aerobically fit obese men still had a 30 percent higher likelihood of death.

Although the study’s results were limited due to the observation of only males, they reinforce the negative implications of obesity. Researchers also believe their findings help disprove the idea that increased aerobic fitness can negate the effects of obesity.

According to the Centers for Disease Control and Prevention, more than one-third of adults in the United States are obese. This amounts to approximately 78.6 million people.

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